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TEST #5 F&E
Patho
| Question | Answer |
|---|---|
| what is the purpose of fluids in the body? | transportation, electrical conductions, energy production, nad maintaining homeostatis |
| where are fluids in the body found? | intra cellular fluid, extracellular fluid, intravascular and interstitial |
| pressure of H2O against the membrane | osmotic pressure |
| the pressure produced by or associated with osmosis and dependent on molar concentration and absolute temperature | osmotic pressure |
| amoutn of the concentration of the solution | osmolarity, osmolality |
| directional movement of the fluid | tonicity |
| no movement of fluid and replaces lost fluid | isotonic |
| shifts fluid out of the vessles into cells or tissue | hypotonic |
| shifts fluid from the cells and tissue into the vessels | hypertonic |
| what does a high osmolarity/osmolality mean? | more concentration with less fluid |
| What does a low osmolarity/osmolality mean? | a lower concentration with more fluid |
| describe the fluid movement of the infusion of isotonic solution into veins | no fluid movement |
| describe the movement of the infusion of hypertonic solution into the veins | fluid movement into veins |
| describe the fluid movement of the infusion of hypotonic solution into the veins | fluid movement out of the veins |
| when fluid is not in vascular space or in the cells. this causes ____ | third space...edema |
| > pressure of the capillary in which fluid begins to leak out | capillary filtration pressure |
| looking from the vascular side and the plasma proteins keep fluids from shifting into weird places | capillary colloidal pressure |
| pressure outside of the vessel, pushing back into the capillary system | interstitial hydrostatic pressure |
| looking from the cell side and plasma protins keep fludis from shifting into wierd places | tissue colloidal osmotic pressure |
| where does the biggest water fluid intake come from? | water beverages |
| water chases ____ and ___ | glucose and Na |
| what is the normal concentration of Na? | .9% |
| if fluid was hypotonic, what % of saline would be given to a pt? | 0.45% or 1/2 of Normal Saline |
| If fluid levels where hypertonic, what % of saline would you give to a pt? | 3% normal saline ex: edema and burned pt |
| what part of the loss of water cannot be calculated? | insensable water loss (ex: sweating, lung water from talking and coughing) |
| what is the best way to tell if there is a balance or inbalance of fluids? | weigh the pt each day at the same time, with the same clothes on, and the same scale |
| what causes the biggest loss of water from the body? | urination |
| accumulation of interstitial fluids and can be localized or generalized | edema |
| termed used for water edema | hydro edema |
| term used for water shift to the belly | ascites edema |
| term for fluid in the spaces around membrane | effusion edema |
| water makes up ____ of body fluids | 90-93% |
| Na makes up ____ of extracellular fluid | 90-95% |
| ___ regulates the extracellular fluid | Na |
| what are the sources of Na? | canned or boxed food, stuff outside cell, and in GI secretions |
| how is Na secreted? | through urine and GI tract |
| what is the role the kidneys play with Na? | kidneys regulate the amount of Na in the blood stream |
| ___ holds in Na. Na holds in ____ | aldosterone...water |
| there is a high concentration of ___ outside of the cell | Na |
| ___ triggers dehydration and < volume of water | thrist |
| hypodipsia | < thirst |
| polydipsia | excessive thirst (ex: in DM pt) |
| hormone that prevents you from urination | antidiuretic hormone |
| what is diabetes insipidus? | when a pt has to go go go (> urination like in a DM pt) |
| what does a SIADH (syndrome of inappropriate antidiuretic hormone) do? | this is when you hold in urination too much |
| what are the 3 main causes of hypovoliema (fluid volume deficit)? | insufficient intake and inadequate replacement, and excessive fluid loss |
| abnormal deficiency of protein in the blood | hypoproteinemia |
| fluid volume deficit | hypovoliema |
| fluid volume excess | hypervoliema |
| what are the causes of hypervoliema or fluid volume excess? | escessive intake, excessive use of saline edemas, steroid therapy, heart failure, liver failure, stress, remobilization after a burn tx, hypertonic or hyperosmolar solutions |
| what are some major s/s of hypervoliema (fluid volume excess)? | tachycardia, hypertension, wt gain, JVD, tachypnea, dyspnea, crackles, cough, peripheral edema, < HCT, < BUN, < specific gravity |
| measures osmolarity | specific gravity |
| low blood Na | hyponatremia |
| having too much Na or water in the blood vessels, which causes an > in the ICF pressure | hypertonicity |
| too little Na or water in the blood vessles, causing a < in the pressure of the ICF | hypotonicity |
| euvolemic | normal fluid volume |
| what are the ways to lose Na out of the GI tract? | GI suction, vomiting, diarrhea |
| passage ways the body makes that you were not born with | fistulas |
| what are the early s/s of hyponatremia? | n/v/d, abdominal cramps |
| what are the main s/s of hyponatremia? | weakness, fatigue, anorxia |
| what are the late s/s of hyponatremia? | tremors, seizures, lethargy, mental confusion, disorentation |
| high blood Na | hypernatremia |
| an excessive loss of water will cause hypernatremia b/c ___ | Na levels will get HIGH if there isn't enough fluid |
| what are the major s/s of hypernatremia? | tachycardia, weak pulse, postural HTN, thirst, low grade temp, tachypnea, oliguria, > BUN, > osmolarlity, > Na, > HCT, > RBC |
| reduced secretion of urine | oliguria |
| is vital to the acid-base balance | Na |
| the ___ balance is found inside of the cells | K |
| second most abundant cation | K |
| major cation of the ICF | K |
| ___ outside of cell, ____ inside of cell | Na....K |
| critical in osmotic and acid-base balance, kidnesy's ability to concentrate urine, necessary for growth, carb, gluscose, and protein metabolism, and electrical conduction | K |
| what is the usual source of K intake? | diet |
| what are the main sources of excretion of K? | kidneys, stool, sweat |
| describe Na and K relationship | inversely proportional= Na up, K down....Na down, K up |
| ____ shifts between ICF and ECF in attempts to maintain balance | K |
| what influences K shift between ICF and ECF | insulin, B-adrenergic stimulation, serum osmolarity, acid-base balance, and exercise |
| low K in blood | hypokalemia |
| what are the main causes of hypokalemia? | < intake, diuretics |
| what are the main s/s of hypokalemia? | orthostatic HTN, muscle weakness and cramping, parasthesia,hyperglycemia, metabolic alkalosis, dyspnea, polyuria, polydipia, ECG changes, and cardiac arrest |
| what are the ECG changes in hypokalemia? | flat t wave, presence of U wave, depressed ST segment. prolonged QT and PR interval, dysrhythmiass |
| what are the most dangerous s/s of hypokalemia? | cardiac dysrythmias b/c they are a deadly sign |
| how should you adm an K IV? | slowly and diluted...not as a push |
| high K in blood | hyperkalemia |
| what are the main causes of hyperkalemia? | renal impairment, K sparing diuretics, ACE inhibitors, burns |
| what are the ECG changes in hyperkalemia? | tall, narrow, peaked T wave...wide QRS...prolonged PR interval...flattened to absent P wave...dysrhythmias (life threatening) |
| most of __ is found in the bones | Ca |
| what are the main functions of Ca? | bone formation and metabolism, neural transmission and function, initiates skeletal muscel contraction, and maintains cell membrane integrity |
| enters through GI tract | Ca |
| must have ___ from Ca to be efficient | Vit D |
| where is Ca excreted? | to the kidneys and GI tract |
| __ and ___ play a big role in the excretion of Ca | PTH and calcitonin |
| what is the relationship between Ca and Ph? | inversely proportional= Ca up, Ph down...Ca down, Ph up |
| Ca and ___ are directly proportional | Mg.....Mg up, Ca up.....Mg down, Ca down |
| what are some main causes of hypocalemia? | < intake, < absorption, > secretion |
| what are the main s/s of hypocalemia? | parasthesia, Chvestak's sign, trousseau's sign, > DTR, pathological fracture, skin hair and nail changes, larygospasms, stridor, bruising, bleeding, ECG changes |
| what are the ECG changes in hypocalcemia? | prolonged QT interval,dysrythmias |
| body doesn't take ___ supplements well | Ca |
| high Ca in the blood | hypercalcemia |
| what are the main causes of hypercalcemia? | hyperparathyriodism, malignancy, immoblization, renal impairment |
| what are the main s/s of hypercalcemia? | anorexia, N/V, abd pain, < bowel sounds, constipation, neuromuscular weakness to flaccidity, < DTR, confusion, depression, lethargy. stupor, coma, renal calculi, ECG changes |
| what are the ECG changes for hypercalcemia? | shortened QT interval, inotropic effect, dysrhythmias |
| second most abundant ICF cation | Mg |
| cofactor for many enzyme activity | Mg |
| essential for ATP synthesis, DNA replication and transcription, cellular metabolism, membrane functions, nerve conduction, ion transports, and Ca channel activity | Mg |
| ingested through diet | Mg |
| how is Mg excreted? | through kidneys |
| what are the ECG changes in hypomagnesemia? | prolonged QT interval, dysrhythmias |
| low Mg in the blood | hypomagnesemia |
| high Mg in the blood | hypermagnesmia |
| what are some causes of hypermagnesmia? | > intake, use of Mg antacids and laxatives, renal impairment, endocrine disorders, acidosis |
| what are 3 endocrine disorders that may cause hypermagnesmia? | hypoparathyroidism, hypoaldosteroneism, and hypothyroidism |
| what are some main s/s of hypermagnesmis? | bradycardia, hypotension, muscle weakness, <DTR, resp. impairment, lethargy |
| indirect measure of H ion concentrations | pH |
| a substance that can give up an H ion; result of cellular metabolism | Acid |
| carbonic acid....exhalable | volatile |
| sulfuric, uric acid...excreted in kidneys | nonvolatile |
| blood pH < 7.35 | acidosis (acid) |
| a substance that can accept an H ion | base |
| ___ is the primary base in the body | bicarb |
| blood pH > 7.45 | alkalosis (base) |
| a blood pH between ___ and ___ is incompatible with life | <6.8 and >7.8 |
| what are some chemical buffers in the acid-base system? | bicarb-carbonic acid...phosphate system...ammonium...some proteins |
| chemical buffers are an ____ system | immediate response |
| the most important chemical buffer and is generateed int he kidneys and aids in the elimanation of H | bicarb-carbonic acid |
| chemical buffer that aids in excretion of H by the kidneys | phosphate system |
| chemical buffer that is added to ammonida in the renal tubules to form ammonium | ammonium |
| chemical buffer that aids in buffering ECF | certain proteins |
| what are the 3 parts of acid-base regulation? | chemical buffers, respiratory system, and renal system |
| regulates teh excretion or retention of carbonic acid | respiratory system |
| if pH <, the resp rate and depth ___ | > |
| if pH >, the resp rate and depth ___ | < |
| fast but weak acid-base regulator | respiratory system (responds within minutes) |
| slow but powerful acid-base regulator | renal system (responds within 48 hrs) |
| regulates the excretion or retention of bicarb and the excretion of H and nonvolatile acids | renal system |
| if pH <, kidneys ____ bicarb | retain |
| if pH >, the kidneys ____ bicarb | excrete |
| losing bases | metabolic acidosis |
| deficit of bicarb | metabolic acidosis |
| what are the causes of metabolic acidosis? | ketoacidosis, renal failure, diarrhea |
| what are the main s/s of metabolic acidosis? | weakness, tremors, tachypnea, hypothension, confusion, lethargy, dysrhythmias |
| what is Kussmaul's? | when pt is panting to get more expiration out (mouth breathing) |
| how does the body compensate with metabolic acidosis? | lungs > rate and depth of ventilation...PaCO2 levels <...change is rapid, usually within minutes to hours |
| gaining > bases | metabolic alkalosis |
| what are the main causes of metabolic alkalosis? | NG suction, K losing thru diuretics |
| what are the main s/s of metabolic alkalosis? | bradypnea, parasthsia, confusion, > muscle irritability, tetany, seizures, coma |
| what are compenstations for metabolic alkalosis? | lung < rate and depth of ventilation...PaCO2 levels >...change is rapid, usually within minutes to hours |
| excessive retention of CO2 | respiratory acidosis |
| what are the main causes of resp acidosis? | airway obstruction and hypoventilation |
| what are the main early s/s of resp acidosis? | tachycardia, tachypnea, diaphoresis |
| what are the late s/s of resp acidosis | bradycardia and hypotension |
| what are the compensations for resp acidosis? | kidneys reabsorb more bicarb or excrete more H...bicarb and base excess levels >...change is slow and may take 2-3 days |
| excessive elimination of CO2 | respiratory alkalosis |
| what is the main cause of respiratory alkalosis? | hyperventilation, anxiety |
| what are the main s/s of resp alkalosis? | tachyardia, palpitations, dry mouth, anxeity, profuse perspiration, parasthseia, inability to concentrate |
| what are the compensations for resp alkalosis? | kidneys excrete more bicarb...bicarb and base excess levels...change is slow 2-3 days |
| what is a tx for resp alkalosis? | breath into paper bag |
| kidneys will shut down if ___ | urine is not made |
Created by:
TayBay15
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